<!DOCTYPE html>
<html>
<head>
    <meta charset="utf-8">
    <title>信息--layui后台管理模板 2.0</title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1">
    <meta name="apple-mobile-web-app-status-bar-style" content="black">
    <meta name="apple-mobile-web-app-capable" content="yes">
    <meta name="format-detection" content="telephone=no">
    <link rel="stylesheet" href="/static/layui/css/layui.css" media="all" />
    <link rel="stylesheet" href="/static/css/public.css" media="all" />
</head>
<body class="childrenBody">
<form class="layui-form linksAdd">
    <input type="hidden" value="" id="id" name="id">
                    <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="mzh" name="mzh" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tjbh" name="tjbh" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tjcs" name="tjcs" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="fccs" name="fccs" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="xm" name="xm" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tcid" name="tcid" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tjlx" name="tjlx" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="htid" name="htid" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="dwid" name="dwid" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="gzdw" name="gzdw" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="yytjrq" name="yytjrq" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tjrq" name="tjrq" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tjys" name="tjys" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="tjczy" name="tjczy" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="fcrq" name="fcrq" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="fcgy" name="fcgy" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="jkz" name="jkz" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="zypd" name="zypd" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="djrq" name="djrq" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="djczy" name="djczy" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="djsm" name="djsm" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="jkda" name="jkda" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="advice" name="advice" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="summary" name="summary" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="state" name="state" lay-verify="required" placeholder="请输入">
        </div>
    </div>
                <div class="layui-form-item">
        <label class="layui-form-label"></label>
        <div class="layui-input-block">
            <input type="text" class="layui-input" id="ydjid" name="ydjid" lay-verify="required" placeholder="请输入">
        </div>
    </div>
            <div class="layui-form-item">
        <button class="layui-btn layui-block" lay-filter="addHisTjDjb" lay-submit>保存</button>
    </div>
</form>
<script type="text/javascript" src="/static/layui/layui.js"></script>
<script type="text/javascript" src="/static/js/hisTjDjb/info.js"></script>
</body>
</html>